This example illustrates that confronting the feared situation is necessary, but insufficient. Many people with social anxieties force themselves to interact with others in their feared situations. They will eat at restaurants, speak in a small group discussion, or answer questions when called on. But, like Phillip, they leave the scene and worry incessantly that they made a fool of themselves or will suffer dire consequences because of their humiliating actions. Along with entering your fearful arenas, you must specifically address your fear of others' judgments and your own harsh self-criticism.

6. You may also need to develop certain social skills.

Some people, in addition to feeling anxious about social interactions, are not confident of what behaviors are most socially appropriate. This is understandable if you have been socially withdrawn most of your life, or if your parents were also inhibited and failed to model interactional skills, or were critical of your social behaviors without instructing you in the correct actions. Such needed skills may include: how to initiate conversation and pastime with others; body posture, facial expressions, and eye contact; formal presentation skills; grooming; and assertive communication.

7. Other problems may get in your way.

Studies of people with social phobia indicate that seventy percent also suffer from at least one other psychological problem. Sixty percent have another phobia and forty-five percent have agoraphobia or panic disorder. Almost forty percent experience some form of depression. One study found that seventy percent meet the criteria for avoidant personality disorder. (Avoidant traits include pervasive social anxiety, loneliness, low self-esteem and the belief that others dislike you or will take advantage of you.) In addition, people sometimes use alcohol as a means of coping with the problem. Approximately twenty percent of those with social anxieties turn to alcohol in an attempt to self-medicate.

There are many ways in which you can help yourself overcome your social discomfort. In the following pages I will outline a positive approach based on the principles of this book. However, if you think that your difficulties are more than you can manage while using the support of your family and friends, then turn to a mental health professional who specializes in the treatment of social phobias using cognitive-behavioral therapy. There is now a growing number of caring and competent specialists who treat these problems.

Also, specialists sometimes recommend medications to assist you during treatment.

next: How to Get Comfortable